Treatment of Anal Fissures with Botulinum Toxin
One method for treating chronic anal fissure is botulinum toxin injection, which temporarily relaxes the sphincter and allows the fissure to heal. It is an outpatient procedure performed without hospitalisation that, in many cases, helps avoid surgery. The choice of treatment method is made by a proctologist following a clinical assessment.
Registration: Mon.–Fri. 9:00–20:00. Gdańsk, ul. Toruńska 15. Price: from 1500 PLN
| Symptoms | severe pain during defecation, burning, bleeding |
| Method | botulinum toxin injection into the anal sphincter |
| Procedure time | a few to several minutes, outpatient |
| Effect | first relief within a few days |
| Diagnostics | consultation + anoscopy |
| Price | from 1500 PLN |
Dr. Godyńska, Dr. Szul, Dr. Smok
no hospitalisation, home the same day
consultation + anoscopy if needed at the same visit
private proctology clinic
Why doesn't an anal fissure heal on its own?
The key problem in chronic anal fissure is excessive tension in the internal sphincter muscle. This causes tissue ischaemia and impairs healing, creating a vicious cycle: pain → muscle spasm → reduced blood supply → no healing → pain. Conservative treatment (ointments, diet, sitz baths) may not be sufficient once this mechanism becomes established.
How does botulinum toxin work in fissure treatment?
Botulinum toxin — injected directly into the internal sphincter — temporarily blocks neuromuscular transmission and relaxes the muscle tension. This improves blood supply to the fissure area and creates conditions favourable for healing. The effect of the toxin typically lasts around 2–3 months — in many cases, this is enough time for the fissure to heal and break the vicious cycle of pain. After this period the muscle gradually regains its function.
Who is botulinum toxin indicated for?
The procedure is particularly considered when conservative treatment has not produced improvement, the fissure is chronic, or symptoms — pain during defecation, burning, spasms — are severe. In many cases this method helps avoid surgery. The proctologist qualifies the patient for the procedure following a clinical examination, taking any contraindications into account.
Diagnostics before the procedure
Treatment is preceded by a proctological consultation and — if needed — anoscopy. Similar symptoms (pain, bleeding during defecation) can also be caused by hemorrhoids or other anal conditions — it is important to establish the cause before starting treatment.
What to know before the procedure — risks and limitations
Botulinum toxin is a method with documented efficacy in the treatment of chronic anal fissure; however, like any treatment, it carries risks and limitations that the doctor discusses with the patient before the procedure.
Relaxation of the sphincter muscle may lead to temporary difficulty controlling gas or stool. Symptoms are usually mild and resolve once the toxin wears off.
In some patients the fissure may recur after the toxin effect wears off. In such cases the proctologist assesses whether retreatment is appropriate or considers other methods.
Certain conditions and medications may be a contraindication to botulinum toxin. The proctologist assesses each patient individually before qualifying them for the procedure.
If botulinum toxin treatment does not produce the expected result or the fissure recurs, the proctologist may refer the patient for surgical treatment of the fissure (lateral internal sphincterotomy). The decision always depends on the clinical picture and course of the disease.
Proctologists — Wyspa Medycyny Przyjaznej, Gdańsk
Proctologist and surgeon specialising in the treatment of anal and rectal conditions, including chronic anal fissures.
Proctologist and surgeon with experience in treating anal fissures, hemorrhoids, and other proctological conditions.
Chronic anal fissure — book a proctological consultation in Gdańsk
Dr. Sara Godyńska · Dr. Justyna Szul · Dr. Kamil Smok
Gdańsk, ul. Toruńska 15 · Mon.–Fri. 9:00–17:00
Frequently asked questions
Is the botulinum toxin injection uncomfortable?
The procedure is performed under local anaesthesia, which significantly reduces any sensation during it. There may be only slight discomfort when the anaesthetic is administered. The patient goes home the same day.
How quickly does improvement appear after the procedure?
The first relief usually appears within a few days of the injection, with the maximum relaxation effect after 1–2 weeks. Healing of the fissure takes several weeks. The pace of improvement depends on how long the condition has existed and its severity.
How long does the effect of the toxin last?
The effect typically lasts around 2–3 months. This time is usually sufficient for the sphincter to relax, blood supply to improve, and the fissure to heal — breaking the vicious cycle of pain and spasm. After this period the muscle gradually regains its function.
What risks does the procedure carry?
The most common side effect is temporary weakening of control over gas or stool due to sphincter relaxation. Symptoms are usually mild and transient. The risks, their severity, and any possible contraindications are discussed individually with the proctologist before the procedure.
Can botulinum toxin replace surgery?
In many cases — yes. This method is considered before surgical treatment (sphincterotomy) and in some patients helps avoid it altogether. If toxin treatment does not produce the expected result, the proctologist will discuss further options, including possible surgery. The decision depends on the clinical course.
Proctology — related services
Examination, diagnosis, and qualification for treatment — including assessment of anal fissure.
Details →Diagnostic endoscopic examination of the anal canal — assessment of fissures, hemorrhoids, and other changes.
Details →Symptoms similar to a fissure (pain, bleeding) — the proctologist identifies the cause and selects treatment.
Details →Another condition requiring proctological diagnosis — fistula as a complication of anal conditions.
Details →Anal fissure treatment with botulinum toxin — Gdańsk
Dr. Sara Godyńska · Dr. Justyna Szul · Dr. Kamil Smok
Gdańsk, ul. Toruńska 15 · Mon.–Fri. 9:00–17:00 · tel. 600 006 913
The information on this page is for general educational purposes only and does not replace medical consultation. Qualification for botulinum toxin treatment — including assessment of contraindications and risks — is carried out by a proctologist on the basis of a clinical examination. Wyspa Medycyny Przyjaznej, ul. Toruńska 15 lok. AU1, Gdańsk. Tel.: 600 006 913.